The Specific Aims of this Midcareer Investigator Award in Patient-Oriented Research are 1) to develop and evaluate the efficacy of behavioral interventions designed to increase dietary adherence, improve health outcomes, and enhance quality of life for young children with cystic fibrosis, type 1 diabetes, and those at risk for obesity, and 2) to provide the candidate protected time and resources necessary to mentor postdoctoral fellows and junior faculty members in psychology and pediatrics who are pursuing clinical investigation in behavioral nutrition interventions for children. The Candidate's programmatic research has focused on identifying behavioral factors that compromise dietary adherence and translating this knowledge into behavioral interventions that can be tested in rigorous clinical trials. During the course of this award, the candidate will complete ongoing research studies with young children with cystic fibrosis, type 1 diabetes, and those at risk for obesity. For each population, the objective is to establish the efficacy of behavioral treatments through well-designed clinical outcome studies and disseminate the findings so that standard care for these children can be improved. The candidate also has an established track record of providing mentorship to postdoctoral fellows and junior faculty in psychology and pediatrics. The Training Plan will further the candidate's knowledge of clinical trial design and analysis of health outcomes relevant to the illnesses under study, and allow him to use these additional skills in his mentoring efforts. The Research Plan includes two ongoing projects: an NIH/NIDDK-funded R01 study, "Behavioral Treatment of Eating Problems in Toddlers with Cystic Fibrosis," and a novel study focusing on "Barriers to Dietary Adherence in Young Children with Type 1 Diabetes." In addition, the candidate will continue his collaborative research, funded by the United States Department of Agriculture, on obesity prevention in low-income children. The Mentoring Plan for beginning clinical investigators will consist of 1) individualized mentoring of 2 postdoctoral fellows in psychology and a junior faculty member in pediatrics within the context of the current research plan, 2) training and supervision of the postdoctoral fellows in the development of their own independent research proposals, and 3) participation of postdoctoral fellows in established didactic programs on manuscript and grant writing, design of clinical trials and clinical research methodology, and ethics in clinical research. Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine provide an ideal setting for this award because of the commitment to patient-oriented research, the presence of a strong pediatric General Clinical Research Center, and the institution of new initiatives to promote innovative clinical research including the newly developed Behavioral Core of the GCRC and the training grant in Gastroenterology and Nutrition (T32).